| NPI | 1053382937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX P0532) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CO DR43898) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2016-07-18 |